| Objective:Patients with high risk factors for stroke were checked by vascular ultrasound. Extracted syndrome factors of patients who were diagnosed carotid atherosclerosis (CAS). Analyzed the correlation between canotid artery hemodynamics, carotid atherosclerosis plaque and syndrome factors. So that, the objectification and standardization of diagnostic standard of TCM syndrome pattern can be improved, and beneficial exploration for clinical doctors to prevent and treat stroke can be provided.Methods:By the method of cross-sectional survey,1236CAS patients with high risk factors for stroke who came from Guangdong Provincial TCM Hospital were investigated. Analyzed the correlation between carotid artery hemodynamics, carotid atherosclerosis plaque and syndrome factors.Results:1. The main factors of high risk factors for stroke were hypertension(76.1%), lipid abnormality(75.4%), less physical exercise or physical activity(53.2%),diabetes(40.0%). The following were smoking (29.9%), overweight (20.6%), history of stroke(27.3%), atrial fibrillation or valvular heart disease (11.0%), history of TIA(4.4%).2.20syndrome factors were extracted, including12of disease nature and 8of disease location. Syndrome factor of disease nature of blood stasis appeared the highest frequency, was29.50%%. Syndrome factor of disease location of meridian appeared the highest frequency, was58.69%. Four syndrome factors combination were the most, about61.00%. Among the four syndrome elements, patients with "Wind-Phlegm and Blood Stasis in Collaterals" were about50.2%, those with "Qi deficiency and sputum block and blood stasis" were about25.6%.3. There were statistically significant that history of stroke, history of TIA, atrial fibrillation or valvular heart disease, smoking, diabetes all could affect the distribution of syndrome factor in patients with high risk factors for stroke. On the contrary, hypertension, lipid abnormality, less physical exercise or physical activity and overweight meant no statistically significant. The study showed that some vascular ultrasound outcomes meant statistically significant in affecting the distribution of syndrome factor in patients with high risk factors for stroke, such as Common Carotid Artery (CCA) IMT, Internal Carotid Artery(ICA) diameter, CCA PSV, CCA RI, ICA RI, the number of plaques, the location of plaques, the morphology of plaques, acoustic characteristics of plaques.4. After the correction of multiple factors, the P of Internal Carotid Artery (ICA) diameter was0.023, OR was0.824, those prompted negatively correlated with the change of the ICA diameter and the wind. The P of Common Carotid Artery (CCA) IMT was0.026, OR was1.761, those prompted positively correlated with the change of the CCA IMT and the phlegm. The P of ICA diameter was0.004, OR was0.770, those prompted negatively correlated with the phlegm. The P s of CCA IMT, ICA PSV, ICA diameter were all less than0.05, OR were all more than1, those prompted positively correlated with the changes and the fire (heat). The P of CCA IMT was0.038, OR was0.994, those prompted negatively correlated with Qi deficiency. The Pof numbers of plaque was less than0.05, OR was more than1, those prompted positively correlated with Yin deficiency. The P of ICA diameter was0.002, OR was0.456, those prompted negatively correlated with damp. The P of CCA and ICA diameter were both less than0.05, OR were both less than1, those prompted negatively correlated with meridian. The P of numbers of plaque was0.022, OR was1.790, those prompted positively correlated with kidney. The P s of ICA diameter and PSV were both less than0.05, OR were both more than1, those prompted positively correlated with spleen.5. After the correction of multiple factors, the P s of CCA and ICA diameter were both less than0.05, OR were both less than1, those prompted negatively correlated with Wind-Phlegm and Blood Stasis in Collaterals. The P s of CCA PSV and numbers of plaque were both less than0.05, OR were both more than1, those prompted positively correlated with Wind-Phlegm and Blood Stasis in Collaterals. The P of CCA PSV was less than0.05, OR was less than1, those prompted negatively correlated with Qi deficiency and sputum block and blood stasis. The P of numbers of plaque was less than0.05, OR was more than1, those prompted positively correlated with Qi deficiency and sputum block and blood stasis.Conclusion:1. Hypertension and lipid abnormality, as the most common stroke risk factors, should be strictly controlled.2. Four syndrome factors combination were the most among CAS patients with high risk factors for stroke. This outcome revealed the basic pathogenesis of deficiency complicated with excessiveness. The deficiency of liver and kidney was the fundamental. The pathogenic factors were blood stasis, phlegm, wind and dampness. The main damaged location was meridian.3. The syndrome factor of wind, phlegm, damp, meridian and spleen were negatively correlated with the change of carotid ultrasound vascular diameter, and positively correlated with the change of IMT. The syndrome factor of fire (heat) was positively correlated with the change of carotid artery hemodynamics. The syndrome factor of Qi deficiency was negatively correlated with the change of carotid artery hemodynamics. The syndrome factor of spleen and Yin deficiency were positively correlated with the numbers of plaque. The combination of syndrome factors "Wind-Phlegm and Blood Stasis in Collaterals" was negatively correlated with the change of diameter, and positively correlated with carotid artery hemodynamics and numbers of plaque. The combination of syndrome factors "Qi deficiency and sputum block and blood stasis" was negatively correlated with the change of carotid artery hemodynamics, and positively correlated with numbers of plaque.The vascular ultrasound outcomes could have a certain value to prompt the distribution of syndrome factor in patients.4. By means of strengthening the vascular ultrasound screening of patients with high risk factors for stroke, we can predict the syndrome factors via vascular ultrasound outcomes, provide scientific basis for the standardization of TCM prevention and treatment of stroke. |
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